What is Women’s Health Physiotherapy?

Women’s Health Physiotherapy is the rehabilitation of disorders relating to the pelvis and pelvic floor muscles.

This includes:

  • problems with control of your bladder (urinary incontinence) or bowel (anal incontinence)
  • pelvic organ prolapse
  • problems during or after pregnancy, e.g. pregnancy-related pelvic girdle pain or low back pain or separation of your abdominal muscles (diastasis rectus abdominis)
  • Chronic pelvic pain – pain experienced in the pelvic area (below the belly button and above the hips) lasting six months or longer

Women’s Health Physiotherapists are Physiotherapists who have undergone specialist postgraduate training to enable them to address the specific and unique needs of women with these conditions.

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How can Women’s Health Physiotherapy Help with problems with my bladder or bowel control?

The pelvic floor muscles are a layer of muscles situated deep inside the pelvis. These muscles form a hammock which supports the bladder, bowel and womb (uterus). If these muscles are not working optimally this can result in problems with control of the bladder and bowel. 1 in 3 women will experience problems with their bladder control at some point in their lives and 1 in 10 will experience problems with their bowel control. Sadly, women are often told these problems are a normal part of ageing or are normal after having children and that they should just put up with these problems. This is not true. There is clear evidence that by addressing problems with the pelvic floor muscles Women’s Health Physiotherapy can help with problems with bladder and bowel control. Women’s Health Physiotherapists also use other treatments to help problems with bladder and bowel control such as lifestyle advice, advice about fluid intake and diet, bladder training, use of aids and adjuncts to facilitate pelvic floor muscle training when necessary and advanced rehabilitation of the pelvic floor and core muscles when required.

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How can Women’s Health Physiotherapy help with my prolapse?

The pelvic floor muscles are a layer of muscles situated deep inside the pelvis. These muscles form a hammock which supports the bladder, bowel and womb (uterus). If these muscles are not working optimally this can result in a sinking of the pelvic organs – a condition known as pelvic organ prolapse. In mild cases this may feel like the vagina is more open than usual, or you may experience a bulging sensation inside the vagina or a feeling of heaviness inside the vagina. In more severe cases you may be able to see a bulge outside the vaginal opening. Pelvic organ prolapses are incredibly common – about 50% of all women who have had a baby will have some degree of pelvic organ prolapse and about 45% of all women over the age of 40 will have some degree of prolapse. There is clear evidence that by strengthening the pelvic floor muscles with pelvic floor muscle exercises, Women’s Health Physiotherapy can treat prolapses and the symptoms associated with the prolapse.

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How can Women’s Health Physiotherapy help me during pregnancy and after my child is born?

The pelvic floor muscles work in partnership with the deep layers of your tummy muscles (the transverse abdominis muscle), a muscle at the base of your ribs (the diaphragm) and the deep layers of the muscles supporting the spine (the multifidus muscle) to form your “core” muscles. The “core “muscles provide support to the pelvis and spine. During pregnancy the pelvic floor muscle is challenged by the weight of the developing baby and the abdominal muscles are stretched as your bump grows. This means these muscles cannot work as efficiently as they would if you were not pregnant, therefore reducing the support that the “core” muscles can give to your spine and pelvis. This may result in pain around the lower back and pelvis during and after pregnancy – it is thought that about 20% of all pregnant women will experience pregnancy related pelvic girdle pain and even more will experience pregnancy related low back pain. Sadly, women are often told this is just a normal part of pregnancy and they should just put up with it. This is not true. Women’s Health Physiotherapy can help with pregnancy related pelvic girdle pain and low back pain by giving exercises to strengthen the core stability muscles, exercises to address areas of tension around the pelvic and giving advice on how to manage day to day activities if you have pregnancy related low back pain or pelvic girdle pain. Women’s Health Physiotherapists have undergone specialist training in how to adapt exercises to ensure they are safe for pregnant and postnatal women.
Stretching of the abdominal (tummy) muscles during pregnancy will frequently result in separation of the abdominal muscles after the baby is born (diastasis rectus abdominis). Women’s Health Physiotherapists can give advice on how to look after your abdomen in the early postnatal period to facilitate natural recovery of this condition and provide exercises to rehabilitate this condition.
During and after pregnancy the pelvic floor muscles may simply feel weak without giving any symptoms of incontinence or prolapse. It is important to address this to prevent symptoms developing later in life or during any future pregnancies. Women’s Health Physiotherapists are specially trained in assessing and treating pelvic floor muscle weakness during and after pregnancy.

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What To Expect On Your First Women’s Health Physiotherapy Appointment

All assessments start with a detailed and confidential discussion of your symptoms and how they are affecting your life. Talking about problems with your bladder and bowel control or other problems related to the pelvic floor muscles can be difficult but it is vital for us to gain this understanding so that we can tailor your treatment to meet your own unique, personal goals. You will then be offered an examination. The nature of this examination will depend on the type of problem you have but may involve an external examination of the back or pelvis. It may involve an internal examination of the pelvic floor muscles. An internal examination involves the Women’s Health Physiotherapist carefully and gently placing a gloved finger into the opening the vagina. This enables the Physiotherapist to assess for the presence of any prolapse and how well the pelvic floor muscles are working. If you have problems with your bowel control you may require an examination which involves the Physiotherapist placing a gloved finger into the back passage (anus) to assess the muscles which control the bowel. If either of these internal examinations are required, the Physiotherapist will discuss them in detail prior to the examination and you will be given the choice to have the examination or not. Once the assessment has been completed the Women’s Health Physiotherapist will discuss the findings with you and work with you to develop an individualised treatment plan to enable you to meet your personal goals.

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